title: The effect of endotracheal tube suctioning education of nurses on decreasing pain in premature neonates.
abstract: OBJECTIVE
  Endotracheal tube suctioning (ETS) is a painful and invasive procedure. Studies have shown that the performance of nurses in this procedure is weak, so we conducted a study to evaluate the effect of ETS education for nurses on neonates' pain in neonatal intensive care units (NICUs).
  
  
  METHODS
  In a quasi-experimental study, performance of 25 nurses working in NICU was assessed before and after ETS education by a checklist. In addition pain score of 50 neonates was measured using pain assessment tool (PIPP) one minute before, during and 5 minutes after ETS. The neonates had a gestational age of less than 37 weeks and were intubated (at least for 8 hours and up to 24 hours). A P. value of less than 0.05 was considered as statistically significant.
  
  
  RESULTS
  Mean scores of nurses' performance were significantly different before and after education (P≤0.001) by Wilcoxon test. Friedman test revealed that PIPPs before, during and after ETS were significantly different before and after education (P≤0.05). Mann-Whitney test showed no significant differences between PIPPs before ETS, before and after education (P=0.2), but PIPPs during and after ETS were significantly different (P≤0.01).
  
  
  CONCLUSIONS
  ETS causes moderate to severe pain in neonates. Education improved performance of nurses and decreased pain in neonates during and after ETS. Despite education, neonates will experience mild pain during ETS, so other interventions need to be considerate.
authors.affiliation: PhD student of Nursing, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Zahra S
authors.initials: ZS
authors.lastname: Hadian
authors.forename: Raheleh S
authors.initials: RS
authors.lastname: Sabet
keywords: Education; Endotracheal; Nursing Performance Evaluation; Pain; Premature Infants; Suction